<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ivt_score')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ivt_score" class="form-control form-control" name="row[ivt_score]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Recharge_score')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-recharge_score" class="form-control form-control" name="row[recharge_score]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sign_score')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sign_score" class="form-control form-control" name="row[sign_score]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tfbl')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tfbl" class="form-control form-control" name="row[tfbl]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level_1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level_1" class="form-control form-control" name="row[level_1]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level_2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level_2" class="form-control form-control" name="row[level_2]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level_3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level_3" class="form-control form-control" name="row[level_3]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
